Provider Demographics
NPI:1225497449
Name:PRO-NEUROMONITORING, LLC
Entity type:Organization
Organization Name:PRO-NEUROMONITORING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-551-0257
Mailing Address - Street 1:101C NORTH GREENVILLE AVE
Mailing Address - Street 2:SUITE 239
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-9117
Mailing Address - Country:US
Mailing Address - Phone:214-551-0257
Mailing Address - Fax:
Practice Address - Street 1:101C NORTH GREENVILLE AVE
Practice Address - Street 2:SUITE 239
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-9117
Practice Address - Country:US
Practice Address - Phone:214-551-0257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty